When a patient is suffering from continuous low back pain and if six months of aggressive conventional (non-surgical) treatment has failed to help and especially if other symptoms, including pain, is making it hard to complete everyday activities, then back surgery is an option to bring about pain relief and restore ones’ potential to function. For patients in this condition, this article will give the patient a summary of about the two types of back surgery currently available:
Lumbar Spinal Fusion
Normal approach to treat pain and/or disability from lumbar degenerative disc disease is spinal fusion. This surgery involves making a direct bony connection between the vertebrae surrounding the painful discs; by stopping motion of the painful discs & which can give the patient relief from pain. There are plenty of options available with spinal fusion, each one having its own advantages and disadvantages. Surgical methods include fusion approached from the front, back or both. Spinal instrumentation in the form of pedicle screws and/or intervertebral cages provide internal structural help while bones fuse, and bone graft can either be harvested or one of a number of synthetic bone graft surrogate or extenders can be used from the patient themselves.
Lumbar Artificial Disc Replacement
With artificial disc replacement, pain relief is brought by removal of the painful disc and motion is maintained by using a prosthetic implant made of metal, without or with a plastic bearing surface. This is somewhat more similar in theory to the artificial hip, knee and the shoulder joints that the Orthopaedic surgeons have been using it for more than 35 years to maintain the range of motion and to get relief from the pain of arthritic extremity joints. But there is a significant difference that only one of the three joints is present at each vertebral level is being replaced, whereas in a knee or hip joint the total joint is replaced.
Fusion Surgery is Most Prevalent
By far till now, fusion surgery is still the most prevalent surgery, and patients should be aware that most of them won’t be eligible for disk replacement as it can treat only limited types of disc pathology. Some are considered same for certain types of artificial disc replacement and fusion. Like, for example, an anterior approach is used for both artificial disc replacement and for an anterior lumbar interbody fusion, which means that risks and potential complications are similar for both the surgeries. Well, for most of the part, there are unique considerations for every type of surgery, and the patients are well advised to get as much educated as possible when considering these two surgeries and analyze their options thoroughly with their treating or consulting physicians.
Determining the Right Treatment for Back Pain
Prior to, considering any type of surgery, patients with chronic low back pain should remember that not all pain are treatable by surgery. The collapse of non-operative treatment doesn’t mean that surgery is necessary to be the next step. Estimation with X-rays and MRI scan may be enough for the surgeon to give an opinion, but other tests including provocative discography and CT scan may be required to determine if surgery is suitable and if both artificial disc replacement and spinal fusion are options.
- Spinal Fusion
- Artificial Disc Replacement (ADR or Total Disc Replacement or TDR)
Lumbar Spinal Fusion
Normal approach to treat pain and/or disability from lumbar degenerative disc disease is spinal fusion. This surgery involves making a direct bony connection between the vertebrae surrounding the painful discs; by stopping motion of the painful discs & which can give the patient relief from pain. There are plenty of options available with spinal fusion, each one having its own advantages and disadvantages. Surgical methods include fusion approached from the front, back or both. Spinal instrumentation in the form of pedicle screws and/or intervertebral cages provide internal structural help while bones fuse, and bone graft can either be harvested or one of a number of synthetic bone graft surrogate or extenders can be used from the patient themselves.
Lumbar Artificial Disc Replacement
With artificial disc replacement, pain relief is brought by removal of the painful disc and motion is maintained by using a prosthetic implant made of metal, without or with a plastic bearing surface. This is somewhat more similar in theory to the artificial hip, knee and the shoulder joints that the Orthopaedic surgeons have been using it for more than 35 years to maintain the range of motion and to get relief from the pain of arthritic extremity joints. But there is a significant difference that only one of the three joints is present at each vertebral level is being replaced, whereas in a knee or hip joint the total joint is replaced.
Fusion Surgery is Most Prevalent
By far till now, fusion surgery is still the most prevalent surgery, and patients should be aware that most of them won’t be eligible for disk replacement as it can treat only limited types of disc pathology. Some are considered same for certain types of artificial disc replacement and fusion. Like, for example, an anterior approach is used for both artificial disc replacement and for an anterior lumbar interbody fusion, which means that risks and potential complications are similar for both the surgeries. Well, for most of the part, there are unique considerations for every type of surgery, and the patients are well advised to get as much educated as possible when considering these two surgeries and analyze their options thoroughly with their treating or consulting physicians.
Determining the Right Treatment for Back Pain
Prior to, considering any type of surgery, patients with chronic low back pain should remember that not all pain are treatable by surgery. The collapse of non-operative treatment doesn’t mean that surgery is necessary to be the next step. Estimation with X-rays and MRI scan may be enough for the surgeon to give an opinion, but other tests including provocative discography and CT scan may be required to determine if surgery is suitable and if both artificial disc replacement and spinal fusion are options.
